TDK conference 2017

We’ve compared three hematology devices (one impedance and two laser types), to find differences in blood analyses of patients with haemopoietic malignancies, compared to the manual smear analysis.

Blood samples from the tested individuals were collected in K3-EDTA tubes, and measured by Abacus Junior 5 Vet, Siemens Advia 120, and Sysmex Xt-2000iv hematology analyzers within 24 hours after sampling,blood smear analysis and immunophenotyping were also performed, the latter by FACS analysis.The smears were examined by counting250 cells of all samples.

14 dogs and 2 cats were examined; seven dogs suffered by chronic small lymphocytic leukemia (CLL); three dogs with CLL and higher numbers of large lymphocytes; four dogs with acute lymphoblastic leukemia (ALL); and two cats with systemic mast cell tumor.

Based on the results of impedance technique machine (Abacus Junior 5 Vet), we suspected CLL in all CLL cases, although the percentage results showed significant difference compared to the smear analysis. In ALL cases the impedance device mixed the large lymphocytes with neutrophil granulocytes (deviation of neutrophil count was35,3% compared to smear analysis).

Advia 120 had almost the same results in cases of CLL, compared to the smear analysis, while in patients with ALL, lot of large lymphocytes were detected as small lymphocytes (deviation of small lymphocyte count was 34% compared to smear analysis). LUC value was the one third of the total large lymphocyte count.

SysmexXt 2000iv has given almost the same percentage of smear analysis for CLL cases. Large lymphocytes in ALL cases were detected as monocytes (deviation in monocyte count was44,2% compared to smear analysis). This machine provides a possibility to re-identify cells of which populations are hanging out of the edges of the normal gates. This technique could improve the accuracy of the measurement, in patients with higher populations of large lymphocytes.

The aforementioned details were more observable in the cats with systemic mast cell tumor. Impedance machine detected them as neutrophils (deviation of neutrophils: 56.3%), while two laser cell counters detected them as monocytes.The subsequent manual analysis with Sysmex could determine mast cells more accurately. It identified them as lysis resistant cells (LRR).

Conclusion: CLL cases were measured reliably by the three automated hematology analyzers. The impedance device could not recognize large lymphocytes. The laser machines determined some of them as monocytes, but the manual analysis of Sysmex proved to be the more accurate.